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Doctors working in accident and emergency departments are
finding it increasingly difficult to provide cost effective care for
patients. In the management of patients with painful limb injuries the
use of less expensive strong analgesia may seem appropriate. On p 1247
Rainer et al show, however, that when additional emergency department
and hospital costs are taken into account, the more expensive ketorolac
is no more expensive than morphine. If emergency department and
pharmacy costs are considered separately from total hospital costs,
then ketorolac is cheaper, gives equal pain relief, is associated with
less severe and fewer adverse effects, shortens patients' stay in the
emergency department, and is associated with greater patient satisfaction.